scholarly journals SEVER INFERIOR HUMERAL HEAD SUBLUXATION FOR 3 MONTHS IN PROXIMAL HUMERUS FRACTURE DISLOCATION

2021 ◽  
Vol 9 (08) ◽  
pp. 870-873
Author(s):  
Emad M. Allehyani ◽  
Ahmed K. Alsarhani ◽  
Ahmed Alsyed
Keyword(s):  
Humeral Head ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Axillary Nerve ◽  
Fracture Pattern ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Medical Illness ◽  
Patient Factors

Proximal humerus fracture is common fracture 4-6% of all fractures (1), third most common non vertebral fracture in elderly >65 years (2), affecting female more than males in ratios of 2:1.Approximately half (51%) of these fractures are displaced, the majority of which involve the surgical neck (77%). (3) Surgical treatment (mainly internal fixation or humeral head replacement) is being increasingly used (4).Management of each fracture is dependent of patient factors, fracture pattern, and complexity.Case scenario:33 years old female not known to has any medical illness, presented to the emergency department with right shoulder pain and inability to move it after motor cycle accident. X-rayshowed proximal humerusfracture dislocation Upon Post-operative follow up patient developed sever inferior humeral head subluxation, With intact axillary nerve sensation and motor exam.Discussion:proximal humerus fracture is common, fracture pattern and type, with patient factors will guide your management.proximal humerus fracture dislocation is more difficult and challenging to surgeon in managing such fracture, with inferior hemeral head subluxation is common can reach to 42% in the radiographic incidence among proximal humerus fracture.

scholarly journals Fracture Dislocation of Shoulder

2014 ◽  
Vol 3 (2) ◽  
pp. 44-45
Author(s):  
Hemanta Kumar Manandhar ◽  
Pramod Devkota ◽  
Padam Bahadur Khadka ◽  
Chakra Raj Randey
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Good Range

Simultaneous dislocation of shoulder with fracture of the ipsilateral humerus is extremely rare and very little reported in the literature. We report a case of forty three year old man who got right shoulder dislocation with proximal humerus fracture. The patient was treated with open reduction and internal fixation by three 4.5mm screws. The operation went uneventful and has good range of motion of the shoulder after six months of follow up. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9529   NOAJ July-December 2013, Vol 3, Issue 2, 44-45

scholarly journals Primary Hemiarthroplasty Following Severe Proximal Humerus Fracture Dislocations with Irretrievable Humeral Head in Young Patients

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Lim Chia Hua ◽  
Khairul Nizam Siron
Keyword(s):  
Humeral Head ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Young Patients ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Proximal Humerus Fractures ◽  
Range Of Movement ◽  
Humerus Fractures ◽  
Good Range

Neer first popularised the use of primary hemiarthroplasty to treat complex proximal humerus fractures, especially when the humeral head is nonviable or not reconstructable with internal fixations, and with younger patients. A 16-year-old boy had a motor vehicle accident and sustained a closed right proximal humerus fracture dislocation without neurovascular injury. Intraoperatively, due to difficulty retrieving the humeral head which dislocated and positioned behind the clavicle, hemiarthroplasty was done to avoid injuring the brachial plexus, vessels and lung. Mr Y, a 34-year-old man similarly sustained closed left proximal humerus fracture dislocation with an irretrievable head. He too underwent hemiarthroplasty. Both patients were followed up for a year with no pain and fairly good range of movement and muscle power. In complex proximal humerus fractures, there is still debate regarding primary hemiarthroplasty. There are risks of secondary displacement of fracture fragments and head necrosis after internal fixation. Neer and Cofield reported over 90% patients had relief of pain and 66% patients had free range of movement post hemiarthroplasty. Other authors described primary malposition and subsequent migration or deficient osseous integration as a complication after prosthesis. In a thirteen-year observational cohort study of 163 patients with hemiarthroplasty, the overall rate of prosthetic survival was 96.9% at one year, 95.3% at five years, and 93.9% at ten years. Of the factors that were assessed, the age is most important due to factors such as degenerative changes in the rotator cuff, osteoporosis, and motivation to achieve a good range of motion. Successful treatment of acute proximal humerus fractures with prosthetic replacement is challenging to orthopaedic surgeons as it requires proper patient evaluation, good surgical technique, especially in soft-tissue tensioning and stability, and meticulous rehabilitation. In young patients with good bone quality and irretrievable head, hemiarthroplasty is a choice.

Anterior proximal humerus fracture dislocation with concomitant glenoid fracture: An operative challenge! A case report

Trauma ◽  
2021 ◽  
pp. 146040862110195
Author(s):  
Dheeraj Attarde ◽  
Atul Patil ◽  
Nilesh Kamat ◽  
Parag Sancheti ◽  
Ashok Shyam
Keyword(s):  
Case Report ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Alternative Pathway ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Anterior Dislocation ◽  
Bony Union ◽  
Glenoid Fracture ◽  
Deltopectoral Approach

Introduction Combined proximal humerus fracture dislocation and glenoid fracture is a rare combination of injuries which presents technical operative challenges. There is little evidence to guide surgical management. Case Report We report a case of a proximal humerus fracture with anterior dislocation and glenoid fracture treated in the same sitting with open reduction and internal fixation with angular stability locking plate and cannulated screw. The surgical technique involved standard deltopectoral approach with coracoid osteotomy. Conclusion By addressing both fractures operatively at the same time, we reported a satisfactory clinical and functional outcome with bony union of the fracture sites without instability at end of 1 year. Coracoid osteotomy may open an alternative pathway to treat complex proximal humerus injuries with ipsilateral glenoid fracture.

scholarly journals Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years

2012 ◽  
Vol 15 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Ki Won Lee ◽  
Young Joon Choi ◽  
Hyung Sun Ahn ◽  
Chung Hwan Kim ◽  
Jae Kwang Hwang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Humerus Fracture ◽  
Vas Score ◽  
Compression Plate ◽  
The Mean

PURPOSE: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated.MATERIALS AND METHODS: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle.RESULTS: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head.CONCLUSION: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

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